Key Takeaways

The medical system is broken. We’re just pushing pills, and not even asking patients how they eat/sleep.

The majority of Americans are overweight and obese – The standard American diet is slowly killing people

When you consume processed meat, it’s best to consume it with vegetables to prevent a variety of negative side effects on the body

It’s absolutely insane that hospitals are serving processed meat to people receiving chemotherapy

There are so many factors that affect your health – whether you smoke/drink, your diet, your relationships, whether you exercise – so be careful what you attribute a cause to

Joel believes that on average, when you consume saturated fat and dietary cholesterol, your cholesterol will rise

“50,000 feet elevation view – you’d be wise to limit the amount of saturated fat you eat, and that’s endorsed by every major medical society in the world”

Chris thinks differently – “There is no evidence that consuming dietary cholesterol increases blood cholesterol levels in most people, and even when it does, there’s not evidence it increases the risk of a heart attack.”

The top sources of saturated fat, according to Chris

33% comes from pizza, deserts, candy, burritos, tacos, and tortillas

24.5% is unaccounted for but it most likely comes from processed foods

There was a study done that showed 43% of findings coming from observational studies were portrayed in the media as being causal

No one will click on a headline that says “Small association between eating red meat and cancer, but we don’t know what it means, but please read the article anyway”

When we take away observational studies, we’re left with…

Basic science

Randomized clinical trials – these are expensive and rare

Studying centenarians

10x more people live to be over 100 in Loma Linda, California compared with Los Angeles, it’s a blue zone

The majority of Americans are overweight and obese

The Debate Begins – Round 1 – Does processed meat reduce life span?

Chris begins by citing a bunch of studies that show there is no difference in life span between vegetarians and omnivores (people who eat both plants and animals) when you control for the many potential variables (smoking, education, physical activity level etc.)

The World Health Organization has declared you have an 18% increase risk of developing cancer when you consume 50 grams of processed red meat per day (hot dogs, salami, balogna) – Joel

Why? Chris gives the reasons and a good reminder that context is everything

“I’m open to the possibility that a lot of processed meat can be problematic, but you have to consider the context. It won’t have the same effect if someone’s eating a ton of fruits and vegetables vs. someone on a standard American diet. There are no studies that separate that out.” – Chris

“That’s still 50-60,000 people a year that get colon cancer, that wouldn’t get colon cancer if they just stopped eating hot dogs” – Joel

It’s insane that hospitals are serving hot dogs to people getting chemotherapy

A Round 1 Tidbit

The USDA used to advise people to limit their cholesterol intake -they don’t now (after a 2015 revision) – Chris

The USDA releases guidelines every 5 years – these guidelines are then used for helping colleges, elementary schools, and hospitals determine what to serve, food wise

Prior to 2010 the USDA recommended people limit total fat intake, but that has since been changed

Chris is saying that the science changes over time, what was once thought to be true, may very likely be false

Also of interest…

“There is not a single study that compares relatively equivalent groups of people that shows vegetarians or vegans have a life span advantage, period” – Chris

Cholesterol and Saturated Fat – Round 2

Heart attacks weren’t really common until the 1940s – Joel

Every 39 seconds, an American dies of heart disease

“80% of them are preventable. The biggest enemy is smoking and crap diets.”

In became apparent in the early 1950s that diet might play a role

Enough data piled up, that guidelines began to suggest we should limit saturated fat intake – Joel says the below..

The Institute of Medicine advises to eat as little saturated fat as possible

21 international statements (from either the American Heart Association, WHO, etc.) suggest we should limit saturated fat intake

Why? – Basic science. When you eat foods rich in saturated fat (meat, cheese, eggs, etc.), cholesterol receptors on the liver go down (these move cholesterol from the blood to the liver to be metabolized), so cholesterol stays in the blood and builds plaques

Joel points out that blocked arteries are caused by cholesterol – “I’ve never scooped sugar out of a blocked artery. 20% of every blockage is cholesterol.”

Chris punches back

It doesn’t mean the cholesterol is there, because people were eating it

Chris brings up a study that fed people 2-4 eggs a day, which showed that in 75% of cases, this had 0 effect on blood cholesterol levels

25% of people are “hyper-responders” – the dietary cholesterol did increase LDL cholesterol levels modestly, but HDL cholesterol was also increased (lessening the risk of heart disease)

“This is why the guidelines on dietary cholesterol were changed. There is no evidence that consuming dietary cholesterol increases blood cholesterol levels in most people, and even when it does, there’s not evidence it increases the risk of a heart attack.”

“395 of the best done studies in the world say that if you eat more saturated fat, your cholesterol goes up. You eat more saturated fat, coronary heart disease risk goes up.”

In a sense – Joel is saying the studies from the 1940-50s are still very much valid today

Chris doesn’t think so…

“These are observational studies done 50-60 years ago that suffered from all the problems we talked about. We have randomized control studies now. Observational studies were never met to prove a hypotheseis, they were meant to generate a hypothesis.”

One study showed that 0 of the 52 claims that were made in one particular observational nutritional study were replicated later, 5 were replicated in the opposite direction

“Science marches on, we learn more, we change, and now we have randomized control trials that are replacing some of the observational evidence from the 1950s and 60s”

A Quick Recap

Chris’ Take

Joel reciting all of these older studies, isn’t relevant, they are epidemiology studies, the new evidence is based on new understanding and knowledge

Early studies did show some relationships, but they were very short term

With longer term studies, there was no increase in cholesterol on average, when saturated fat intake was raised

When examined for an increase in heart attacks/death, there was no increased risk with increased saturated fat consumption

“There’s no meta analysis of randomized control trials that shows eating more saturated fat will increase the risk of death or heart disease”

Joel’s Take

Saturated fat in the diet, lowers LDL receptors on the surface of the liver, which allows LDL cholesterol to stay in the blood, and therefore get into the arterial wall to create plaques

This is backed by 395 metabolic ward studies, and many epidemiology studies, as well as by observing centenarians/blue zones

“50,000 feet elevation view – you’d be wise to limit the amount of saturated fat you eat, and that’s endorsed by every major medical society in the world, and it’s not controversial”

Joel says the science agrees with the fact that saturated fat increases the risk for heart disease, Chris says it doesn’t

Chris – “We used to think the world was flat, we used to think ulcers were caused by stress; there are a lot of things that have changed over time as the evidence evolves and we become more educated and aware”

“It’s not a conspiracy, it’s just the advancement of science”

Back To It

Chris – The American Heart Assoc., The American Diabetic Assoc, have funding from big food (like Coca Cola)

Joel – Since 1990, 90% of egg studies on nutrition were funded by the egg board

Chris thinks that in 2020, the USDA will change their guideline recommending people limit the amount of saturated fat they intake

Joe (not Joel) thinks the USDA is relying on old science for their guidelines – this is why they eventually changed the guideline for total fat intake

Chris – “I’m not saying saturated fat will never increase LDL cholesterol or particle numbers in certain people, it will in some cases.”

For some people, with specific gene polymorphisms, this might be the case

He’s reporting on the science, on average

A Brilliant Point

The sources of saturated fat in the American diet, according to Chris:

Cholesterol – Round 3

The summary – The cholesterol you eat, is not the same as the cholesterol in your blood. For most people, eating cholesterol won’t raise your blood cholesterol levels.

“Humans are the only free living animal on the planet with a LDL cholesterol over 80, because we eat, and we gorge, and we have jacked up saturated fat that drives up our cholesterol level” – Joel

You want an LDL cholesterol between 50-70

Chris counters – “The evidence is showing that on average, dietary saturated fat and cholesterol, do not raise cholesterol in the blood. And even when they do, it doesn’t translate into an increased risk of heart disease.”

Chris brings up a good point – There are randomized control trial studies on the ketogenic diet (which involves eating a good amount of cholesterol), which show that eating cholesterol doesn’t negatively impact blood cholesterol levels

Joel – It’s been found that levels of TMAO in the blood correlate with how clogged your arteries are

TMAO impairs HDL-C so it doesn’t reverse cholesterol transport, and it causes LDL-C to enter the cell walls to create plaque

If you eat red meat high in l-carnitine (an amino acid) and eggs rich in choline, those directly lead your liver to create TMAO

Chris

Fish is high in TMAO, and increases TMAO in the blood, but consuming fish is also associated with a decreased risk of heart disease, and considered to be relatively healthy by the scientific community – “There are few things associated with a greater reduced risk of cardiovascular disease than fish consumption”

This image shows the increase in blood TMAO levels from eating eggs, beef, cheese, milk, and clams, cod, and halibut – cod and halibut increase TMAO much more than beef and eggs

TMAO is not fully understood, and you can’t say it’s causal of heart disease

High TMAO levels are thought to be indicative of a disrupted gut microbiome

So a person eating a standard American diet (which would disrupt the gut biome), may see an increase in blood TMAO levels when they consume red meat. Someone with a healthy microbiome, might not see this.

Random Yet Important

“Foods have multiple effects. They might have one impact that you might think would lead to harm, but it might have multiple other impacts that would be beneficial” – Chris

Meat you hunt has probably 8x less saturated fat than what you buy at a grocery store

16 of the top 25 sources of selenium come from ocean fish

There are so many factors that affect your health – whether you smoke/drink, your diet, your relationships, whether you exercise – so be careful what you contribute a cause to

Take observational studies with a grain of salt – the fewer the things controlled for, the bigger the grain of salt should be

Studies have shown that the amount you need to supplement with is about 100x the RDA of 2.5 micrograms

If you’re deficient you need 200x the RDA

“It begs the question of whether we should be following a diet that can’t meet our essential nutrient needs, that leads to deficiencies of many other nutrients much more common than an omnivorous diet”

Vegans have much higher rates of iodine deficiency

Whole fat, fermented dairy is one of the best sources of iodine in the diet